Wednesday, August 18, 2010

Linkism

Why it’s a bad idea to move Medicare to voucher scheme, demonstrated. Also, remember that excellent New Yorker article by Atul Gawande about end-of-life care? Here’s some more confirmation of the thesis (palliative care helps you live longer):

In the three-year study [in the New England Journal of Medicine], 151 patients with fast-growing lung cancer at Massachusetts General, one of the nation’s top hospitals, were randomly assigned to get either oncology treatment alone or oncology treatment with palliative care — pain relief and other measures intended to improve a patient’s quality of life. They were followed until the end of 2009, by which time about 70 percent were dead.

Those getting palliative care from the start, the authors said, reported less depression and happier lives as measured on scales for pain, nausea, mobility, worry and other problems. Moreover, even though substantially fewer of them opted for aggressive chemotherapy as their illnesses worsened and many more left orders that they not be resuscitated in a crisis, they typically lived almost three months longer than the group getting standard care, who lived a median of nine months.

Also, paychecks to shrink because of rising health care costs. Very bad in this economy.

So the South Korean President has a plan to reunify the peninsula. Here’s what they’re getting into, a first-hand account of North Korea (this excerpt is from Pyongyang):

Pyongyang is the country's showcase. Living there is a privilege granted only to the regime's most loyal and useful subjects. But besides the grand monuments -- including a larger-than-life version of Paris' Arc de Triumph -- the buildings are all grey, concrete cinderblock structures. Few are taller than eight stories, because they have no elevators. If you look into the windows, every single room -- office or apartment -- has dual portraits of Kim Il Sung and Kim Jong Il hanging on the wall. Along the street, there are no ads or commercial signage, just propaganda posters and billboards. Every few blocks, there are these little blue and white canvas kiosks that sell soft drinks. The sidewalks aren't crowded like in China, and the streets are very broad. At every intersection stands a uniformed policewoman -- handpicked, they say, for their beauty -- directing traffic with parade-ground precision. One thing that really surprised me was the number of luxury sedans and SUVs, brands like BMWs and Mercedes, on the city streets. Obviously somebody has cash and connections.

Everywhere you go in Pyongyang, the skyline is dominated by a huge 105-story concrete pyramid, the Ryugyong Hotel, which looms over the city like the pyramid-shaped Ministry of Truth in Orwell's 1984. It was intended to be the world's tallest hotel, but it turned out to be structurally unsound, so it was never completed. It's been standing there, abandoned, since 1992. It doesn't appear on any official maps, and nobody ever talks about it, because it's such a horrendous embarrassment.

The most memorable thing about Pyongyang, though, is the total darkness that descends at night. Because electricity is in short supply, there are hardly any lights at all -- a couple of bulbs here and there, and the headlights of passing buses. People are out and about, but all you can see are the dark shapes right beside you. Back at the hotel, you look out the window and there's just nothing. It's like the whole city was just swallowed up.

Various European countries are getting ready to withdraw its subsidies for renewable energy (just what we need!), and here’s an excellent article about efforts to develop a new battery from the ARPA-E program:

The Energy Department is putting $4.6 million into Agrivida, and similar sums into other start-up firms, many of them intent on finding gasoline substitutes. It is, said one department official, “real science fiction stuff,” ideas promising enough to attract a few million dollars for research but not quite promising enough to draw the private capital required for small-scale production.

… in order to rebalance the economy China must sharply raise the consumption share of GDP. It has declined from 46% of GDP in 2000, which was already a very low number, although not quite unprecedented, to 41% in 2003, which is, I believe, an unprecedented number, at least for any large economy.

But that wasn’t the end of the story. Consumption declined further as a share of GDP to an astonishing 38% in 2006, finally to end under 36% in 2009. I don’t think we have ever seen anything close to this level before.